Individual
MR. RANDALL RENEE BEECH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
750 AVE D WEST, KINGMAN, KS 67068-1268
(620) 532-3147
(620) 532-5221
Mailing address
PO BOX 780515, WICHITA, KS 67278-0515
(316) 636-1129
(316) 218-0681
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
19302
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004070428
AETNA
KS
01
—
020007135
RAILROAD MEDICARE
KS
05
—
100154100B
—
KS
Enumeration date
07/21/2005
Last updated
11/30/2010
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